哮喘伴肺部感染患者TGF-β1和CRP及T淋巴细胞变化与病情严重程度的相关性  

Relationship between variation of TGF-β1, CRP and T lymphocyte and severity of disease in asthmatic patients with pulmonary infection

作　　者：秦碧媛[1] 曾春芳[1] 李勇谦[1] 王笑[1] 曾建明[1] QIN Bi-yuan;ZENG Chun-fang;LI Yong-qian;WANG Xiao;ZENG Jian-ming(Deyang People’s Hospital,Deyang,Sichuan 618000,China)

机构地区：[1]德阳市人民医院呼吸内科

出　　处：《中华医院感染学杂志》2019年第24期3758-3763,共6页Chinese Journal of Nosocomiology

基　　金：成都中医药大学校基金资助项目(YYZX1400)

摘　　要：目的研究转化生长因子β1(transforming growth factor-β1,TGF-β1)、C-反应蛋白(CRP)及T淋巴细胞水平变化与哮喘伴肺部感染患者病情严重程度相关性。方法选取德阳市人民医院2016年2月-2018年4月哮喘伴肺部感染者86例,为感染组;同期再选取哮喘未伴肺部感染者90例设为未感染组;健康体检者60名为对照组。比较感染组患者疑似感染时(T0)、感染24 h(T1)、感染72 h(T2)和感染控制后(T3)急性生理和慢性健康评分(APACHEⅡ)和血清TGF-β1、CRP、T淋巴细胞水平变化及未感染组和对照组上述指标水平,绘制受试者工作特征曲线(ROC曲线)。结果 T0时,感染组患者APACHEⅡ评分、TGF-β1、CRP、CD8+(%)分别为(15.40±5.20)分、(104.50±16.20)pg/ml、(12.30±1.90)mg/L、(29.00±3.04)%均高于未感染组(6.80±3.60)分、(63.00±12.50)pg/ml、(7.80±1.76)mg/L、(28.50±2.95)%和对照组,未感染组高于对照组(P均<0.05);CD4+(%)为(35.00±4.20)%低于未感染组(37.50±3.24)%和对照组,未感染组低于对照组(P均<0.05)。T1、T2、T3时,感染组患者APACHEⅡ评分、TGF-β1、CRP、CD8+(%)先升高、后下降,CD4+(%)水平先下降、后升高,差异均有统计学意义(P<0.05)。T0、T1、T2、T3时,中重度感染患者APACHEⅡ评分、TGF-β1、CRP、CD8+(%)水平均高于轻度感染患者,CD4+(%)分别为(31.70±3.20)%、(27.10±2.90)%、(29.30±3.00)%、(30.00±3.14)%低于轻度感染患者(P<0.05)。血清TGF-β1、CRP、T淋巴细胞水平及其联合水平变化早期评定哮喘伴肺部感染患者病情严重程度ROC曲线下面积(AUC)分别为0.715、0.793、0.581、0.827,TGF-β1+CRP+T淋巴细胞水平同步变化早期评定哮喘伴肺部感染患者病情严重程度敏感度81.40%、特异性94.44%。TGF-β1、CRP、CD8+(%)水平分别与APACHEⅡ评分呈正相关,CD4+(%)水平与APACHEⅡ评分呈负相关(P<0.05)。结论 TGF-β1、CRP、T淋巴细胞水平变化与哮喘伴肺部感染患者病情严重程度具有一定相关性,加强三者�OBJECTIVE To investigate the relationship between the variation in levels of TGF-β1, CRP and T lymphocyte and the severity of asthmatic patients with pulmonary infection. METHODS From February 2016 to April 2018, 86 patients with asthma and pulmonary infection were enrolled in the infection group. Druring the same period, 90 patients with asthma without pulmonary infection were recruited in the uninfected group;60 healthy subjects were in the control group. To observe and compare the acute physiology chronic health score(APACHEII), levels of serum TGF-β1, CRP, T lymph in the infection group at the time point of suspected infection(T0), infection after 24 h(T1), infection after 72 h(T2) and infection control(T3), as well as in the untreated group and the control group. And the receiver operating characteristic curve(ROC curve) was plotted. RESULTS The APACHE II score, levels of TGF-β1, CRP and CD8+(%) in the infected group at the time point of T0 were(15.40±5.20),(104.50±16.20) pg/Ml,(12.30±1.90)mg/L and(29.00±3.04)%, respectively, which were significantly higher than that in the uninfected group with(6.80±3.60),(63.00±12.50)pg/mL,(7.80±1.76)mg/L and(28.50±2.95)%, and higher than that in the control group;the indexes in the uninfected group was significantly higher than that in the control group(P<0.05). The percentage of CD4+ was(35.00±4.20)%, which was significantly lower than that in the uninfected group [(37.50±3.24)%] and the control group;this index in the uninfected group was significantly lower than that in the control group(P<0.05). During the period from T0 to T3, the APACHE II score, TGF-β1, CRP, and CD8+(%) in the infected group increased earlier and decreased later;the CD4+(%) level decreased earlier and increased later;the differences between them was significant(P<0.05). At the time point of T0, T1, T2 and T3, the APACHE II score, levels of TGF-beta 1, CRP and CD8+(%) in patients with moderate and severe infections were higher than that in patients with mild infections. The CD4+(%) lev

关 键 词：哮喘 肺部感染 病情 转化生长因子Β1 C-反应蛋白 T淋巴细胞 

分 类 号：R563.1[医药卫生—呼吸系统]